Background to this inspection
Updated
18 December 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
We gave the service 24 hours’ notice of the inspection visit as we needed to be sure that the registered manager would be available to support the inspection process.
Inspection activity started on 13 November 2018 when we visited the office location and concluded on 21 November 2018. It included contacting people who used the service and their relatives by telephone and speaking to and receiving written feedback from members of care staff.
The inspection was undertaken by one inspector.
Before the inspection, the provider completed a Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed information available to us about such as information received about the service and notifications. A notification is information about important events which the provider is required to send us.
We looked at three people’s care plans and medication records. We reviewed three staff recruitment files, staff training records and support records. We also looked at other records relating to the overall management of the service, including quality assurance records, to see how the quality and safety of the service was monitored and managed.
Updated
18 December 2018
This inspection commenced on 13 November 2018 and concluded on 21 November 2018 and was announced.
Caremark Watford and Hertsmere is a domiciliary care agency and provides personal care to people living in their own homes and flats in the community. At the time of our inspection 23 people were being provided with a service.
Not everyone using Caremark Watford and Hertsmere received the regulated activity of personal care. CQC only inspects the service being received by people provided with ‘personal care which included assisting people with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
At our last inspection we rated the service requires improvement. Recruitment systems were not consistently followed. At this inspection we found that improvements had been made and the evidence supported the rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.’
People felt safe being supported by staff from Caremark Watford and Hertsmere and reported no concerns in relation to safe working practices.
Staff had a good understanding of safeguarding people and had received training. The provider had policies, procedures and systems in place should they have any concerns. Staff knew how to report and elevate concerns.
Medicines were managed safely by staff who had received training on how to administer people’s medicines safely. There were appropriate infection control practices in place and personal protective equipment was provided.
People were supported by adequate numbers of staff, however some people reported that they did not always have support from the same care workers, in particular at the weekend. We shared this information with the registered manager who had identified this and was working to resolve recruitment issues. There were safe recruitment processes in place with robust checks completed for all staff.
Staff spoke positively about the support and training they received. Training plans were in place and staff were supported by their line manager through regular supervision, team meetings and work based observation and spot checks.
People were supported with their nutritional needs when required and were supported to access the services of a range of health care professionals when required.
Staff gained consent prior to any care being delivered and understood the Mental Capacity Act and how this related to people who used the service. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.
People and their relatives felt staff were kind and caring and treated them with respect. People’s dignity was maintained during support and people were encouraged to remain as independent as possible.
Care plans were detailed and personalised recording people’s individual needs including life histories, likes, dislikes and preferences. Care plans were regularly reviewed and updated regularly which included when any change occurred. People and where appropriate relatives, were involved in the development and review of their care.
People views about their experience of the service was routinely sought from people. Any concerns or complaints received were recorded and investigated by the registered manager. Any learning from such incidents were shared to help reduce the risk of a reoccurrence.
The registered manager and provider had effective quality assurance process in place to monitor the quality of the service and make improvements which included audits of care file, staff files, spot checks and feedback from people who received a service.
Staff meetings were held regularly which staff found useful. People, relatives and staff felt the registered manager was open, and inclusive and they felt the service had improved in recent months.